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Impact of Patient Navigation Services on Cancer Treatment Completion in Nigeria

Abstract

Cancer remains a major public health concern in Nigeria, with patients often facing substantial barriers to completing recommended treatment. These barriers may include delayed diagnosis, high treatment costs, transportation difficulties, limited availability of specialized oncology services, fragmented referral pathways, inadequate information about treatment, long waiting times, and challenges navigating complex healthcare systems. Failure to complete prescribed cancer treatment may reduce treatment effectiveness and adversely affect patients' health outcomes. Patient navigation services provide individualized assistance to cancer patients by helping them understand their treatment plans, coordinate appointments, overcome healthcare-system barriers, access available support services, and maintain contact with healthcare providers throughout the treatment process. Against this background, this study investigates the impact of patient navigation services on cancer treatment completion in Nigeria. The study will be anchored on Andersen's Behavioral Model of Health Services Use, the Health Belief Model, and the Donabedian Model of Healthcare Quality. Andersen's Behavioral Model explains healthcare utilization through predisposing, enabling, and need-related factors, with patient navigation functioning as an enabling support that may improve access to and continued use of cancer services. The Health Belief Model explains how patients' perceptions of cancer severity, treatment benefits, barriers, and cues to action may influence adherence to recommended treatment. The Donabedian Model explains how healthcare structures and processes influence healthcare outcomes, with patient navigation representing a supportive service process that may improve continuity and quality of cancer care. Collectively, these theoretical perspectives provide a suitable framework for explaining how patient navigation services may influence cancer treatment completion in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cohort research design. The study population will comprise adult cancer patients receiving treatment at selected public and private oncology centres in Nigeria. A multistage sampling technique will be used to select states, oncology centres, departments, treatment units, and eligible cancer patients. Patient navigation services will be measured using indicators such as access to a designated patient navigator, frequency of navigation contacts, assistance with appointment scheduling, treatment coordination, referral support, patient education, transportation assistance, financial-resource linkage, communication with healthcare providers, follow-up contacts, and assistance with managing treatment-related barriers. Cancer treatment completion will be assessed using indicators such as completion of prescribed treatment cycles, attendance at scheduled treatment appointments, completion of recommended radiotherapy or chemotherapy courses where applicable, completion of planned surgical treatment, adherence to treatment schedules, treatment interruption, missed appointments, premature discontinuation of treatment, and completion within the clinically recommended treatment period. Data will be collected using structured questionnaires, patient navigation records, oncology treatment records, appointment registers, hospital records, and relevant treatment documentation. Descriptive statistics will be used to summarize patients' demographic and clinical characteristics, navigation-service exposure, and treatment completion patterns. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, survival analysis where appropriate, and logistic or multiple regression analysis, will be used to determine the impact of patient navigation services on cancer treatment completion. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that patient navigation services have a significant positive impact on cancer treatment completion in Nigeria. Cancer patients who receive structured patient navigation are expected to demonstrate higher treatment completion rates, better appointment attendance, and fewer treatment interruptions than patients without access to navigation services. Patient navigators may help patients understand complex treatment plans, coordinate appointments, overcome transportation and financial barriers, improve communication with healthcare providers, and remain engaged throughout the treatment process. Navigation may be particularly beneficial for patients receiving lengthy or complex treatment regimens that require repeated hospital visits. However, limited oncology resources, high treatment costs, inadequate numbers of trained navigators, transportation difficulties, long distances to treatment centres, and shortages of cancer medicines or equipment may continue to affect treatment completion despite navigation support. The study therefore expects accessible, structured, and adequately supported patient navigation services to contribute significantly to improved completion of recommended cancer treatment in Nigeria. The study is expected to contribute to the literature on patient navigation services, cancer treatment completion, oncology care, treatment adherence, continuity of care, healthcare access, cancer survivorship, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Institute for Cancer Research and Treatment, state ministries of health, oncology centres, hospitals, cancer-care professionals, patient-support organizations, development partners, and policymakers regarding strategies for improving continuity of cancer treatment. The study will also provide evidence-based recommendations for integrating patient navigation into cancer-care programmes, training and deploying patient navigators, strengthening referral and appointment coordination, improving financial and transportation support, providing patient-centred treatment information, and developing sustainable navigation systems to support cancer patients throughout the treatment pathway in Nigeria.

Keywords: Patient navigation services, cancer treatment completion, cancer patients, oncology care, treatment adherence, continuity of care, healthcare access, cancer treatment, patient support, Nigeria, public health.